Canada's health requirements for migrants — IRCC medical exam by panel physician and the excessive demand assessment.
Overview
Canada requires immigration medical examinations (IME) for almost all permanent residence applications and many longer-term temporary visa categories. The exam must be conducted by an IRCC-designated panel physician — your regular doctor cannot conduct the exam. Once IRCC issues medical instructions, you have 30 days to complete the exam. The IME assesses general health, tuberculosis (chest X-ray), HIV (testing required since 1989), syphilis, and excessive demand on Canadian health/social services. The 'excessive demand' assessment is unique to Canada — applicants whose health conditions would cost Canadian publicly-funded health/social services more than the cost threshold (currently CAD 128,445 over 5 years, or CAD 25,689 annually) may be denied. This threshold has been adjusted upward over time to be less restrictive. Some categories (refugees, spouses of citizens) are exempt from excessive demand assessment. This guide details the IME procedure, verified against canada.ca.
Pre-Arrival Health Requirements by Visa
| Visa Category | Medical Required? | Notes |
|---|---|---|
| Permanent Resident (Express Entry, PNP, etc.) | Yes — IME by panel physician | 30-day deadline from instruction |
| Work Permit (12+ months OR healthcare/childcare) | Yes — IME | Some shorter work permits exempt |
| Study Permit (12+ months OR healthcare-related) | Yes — IME | Shorter studies often exempt |
| Visitor Visa (TRV) | Generally no | Some specific categories may require |
| Working Holiday | No | Standard category exempt |
| Refugee | Yes — separate procedure | More extensive screening |
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See Paid Plans →Frequently Asked Questions
Do I need a medical exam for a Canadian visa?
Yes for: permanent residence applications (Express Entry, PNP, family sponsorship), work permits 12+ months or in healthcare/childcare, study permits 12+ months or healthcare-related, refugee applications. Generally NOT for: visitor visas (TRV), short-term work permits, Working Holiday visa. The Immigration Medical Exam (IME) must be conducted by IRCC-designated panel physician within 30 days of receiving medical instructions.
How much does a Canadian IME cost?
CAD 200-500 typical. Some panel physicians in major cities (Toronto, Vancouver, Montreal) charge at the higher end. Find panel physicians at canada.ca/find-a-doctor. Includes physical exam, chest X-ray, blood tests (HIV, syphilis), urinalysis, vision/hearing. Vaccination updates extra cost if needed.
What is the excessive demand assessment?
Canadian immigration officers assess whether your health condition would cost Canadian publicly-funded health/social services more than the cost threshold (CAD 128,445 over 5 years or CAD 25,689 annually in 2026). Common scenarios: ongoing kidney disease, diabetes requiring intensive management, HIV with expensive antiretroviral therapy, psychiatric conditions, neurological disorders. If assessed as excessive demand, you receive a Procedural Fairness Letter and can demonstrate mitigation (private insurance, family support).
Am I exempt from the excessive demand assessment?
Yes if you're: refugee, spouse or minor child of Canadian citizen or PR, some humanitarian categories, dependent child sponsored by parent who is Canadian citizen or PR. Most other categories (Express Entry, PNP, family-sponsored adult, work permit, study permit) are subject to excessive demand assessment.
How long is a Canadian IME valid?
12 months from completion. If your immigration application takes longer than 12 months from your IME date, you may need to redo the exam. IRCC will notify you. For Express Entry, you can request to upgrade your IME within the 12-month window.
Does Canada require HIV testing?
Yes — HIV testing is mandatory for IRCC immigration medical exam since 1989. HIV-positive applicants are not automatically denied — but may be assessed for excessive demand if ongoing treatment costs exceed threshold. Many HIV-positive applicants have successfully obtained Canadian PR after providing evidence of treatment compliance and demonstration that private resources can manage costs.
What if my home country requires me to disclose health information?
Canada doesn't share IME results with foreign governments. Your IRCC medical exam is for Canadian use only. Confidentiality is maintained except in narrow circumstances (e.g., public health threats requiring international notification — rare). The exam itself doesn't share information with your home country's health system.
What if I'm assessed as having excessive demand?
Receive a Procedural Fairness Letter outlining the specific assessment. Options to respond: (1) provide medical evidence that condition is misclassified or that costs are overestimated; (2) demonstrate mitigation — private insurance plan, family support, financial resources; (3) demonstrate the condition has improved or treatment costs have decreased. Strong responses can successfully refute excessive demand findings. Legal representation recommended for complex cases.